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Quelle antiépileptique pour traiter les convulsions ?

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Pour la plupart des personnes souffrant d’épilepsie, les médicaments sont utilisés pour contrôler les convulsions. Bien que les différents types d’épilepsie sont très variables, en général, les médicaments peuvent contrôler les convulsions chez environ 70% des patients. Toutefois, ils ne guérissent pas l’épilepsie.

Un diagnostic précis du type de l’épilepsie (Et pas seulement le type de convulsions, puisque la plupart des types de convulsions se produisent dans différents types d’épilepsie) est très important dans le choix du meilleur traitement. Le type de médicaments prescrits dépendra également de plusieurs facteurs spécifiques à chaque patient, tels que les effets secondaires qui peuvent être tolérés par le patient, d’autres maladies qu’il peut avoir, et la si la voie d’administration est acceptable.

Voici une liste de quelques médicaments qui sont actuellement le plus couramment utilisés pour traiter l’épilepsie.

Tegretol ou Carbatrol (carbamazepine)

  1. De première intention pour les crises partielles, tonico-cloniques generalisés et crises mixtes.
  2. Les effets indésirables sont: fatigue, troubles visuels, nausées , vertiges, rash.

Zarontin (ethosuximide)

  1. Utilisé pour le traitement des crises d’absence.
  2. Effets indésirables: nausées, vomissements, perte d’apétit et perte de poids.

Felbatol

  1. Traite les crises partielles et certaines crises géneralisés.
  2. Effets secondaires: perte d’apetit ,perte de poids, insomnie, céphalés et dépression. Il peut rarement causer une insuffisance hépatique ou de moelle osseuse. Par conséquent, l’utilisation du médicament est limitée, et les patients le prenant doivent avoir une formule numération sanguine et des bilans hépatiques réguliers durant le traitement.

Gabitril

  1. Utilisé avec d’autres antiéplieptiques pour le traitement des crises partielles et certaines crises généralisés.
  2. Les effets secondaires habituels incluent vertiges, fatigue, faiblesse, irritabilité, anxiété et confusion.

Keppra

  1. Utilisé avec d’autres antiéplieptiques pour le traitement des crises partielles.
  2. Les effets secondaires incluent fatigue, faiblesse et changements du comportement.

Lamictal

  1. Traite les crises partielles et certaines crises généralisés.
  2. A peu d’effets secondaires, mais rarement on a signalé des vertiges, insomnies ou rash.

Lyrica

  1. Utilisé dans le traitement des crises partielles.
  2. Effets secondaires incluant: vertiges , somnolence , sécheresse buccale, oedèmes périphériques, vision floue, prise de poids et difficultés de concentration/attention.

Neurontin (Gabapentine)

  1. Utilisé avec d’autres antiépileptiques les crises partielles et certaines crises généralisés.
  2. Peu d’effets secondaires durables. Durant les premières semaines de traitement vous pouvez avoir de la fatigue et des vertiges.

Dilantin (Phenytoine)

  1. Contrôle les crises partielles et les crises généralisés tonico-cloniques. Peut aussi etre donné en intraveineux en milieu hospitalier pour controler rapidement une convulsion en cours.
  2. Effets secondaires: vertiges,  fatigue,troubles de l’élocution , acné, rash et augmentation de la pilosité (hirsutisme). Sur le long terme, le médicament peut entraîner un amincissement des os.

Topamax

  1. Utilisé avec d’autres antiépileptiques pour traiter les crises partielles ou généralisés tonico-cloniques.
  2. Les effets secondaires comprennent: somnolence, vertiges, troubles de l’élocution, nervosité, troubles de la mémoire, troubles visuels, perte de poids.

Trileptal

  1. Traite les crises partielles.
  2. Les effets secondaires les plus habituels sont: fatigue, vertiges, céphalés, vision floue ou en double.

Depakene, Depakote (valproate, acide valproique)

  1. Utilisé pour le traitement des crises partielles, crises d’absence et les crises généralisés tonico-cloniques..
  2. Les effets secondaires comprennent: vertiges, nausées, vomissements, tremblements, chutte de cheveux, prise de poids, dépression chez l’adulte, irritabilité chez l’enfant, réduction de l’attention, diminution dans la vitesse de réflexion. A long terme, il peut causer un amincissement des os, enflure des chevilles, irrégularité des périodes menstruelles. Certains effets sont plus rares et plus dangereux: assourdissement, atteintes hépatiques, diminution des plaquettes, More rare and dangerous effects include hearing loss, liver damage, decreased platelets (les cellules de la coagulation) et problèmes pancreatiques.

Zonegran

  1. Utilisé avec d’autres médicaments pour le traitement des crises partielles.
  2. Les effets secondaires incluent somnolence, vertiges, démarche instable, calcules rénaux, une gène abdominale, céphalés et rash.

Valium et tranquillisants similaires comme le Klonopin ou le Tranxene

  1. Traitement efficace à court terme pour tout les types de crises. Souvent utilisé dans les salles d’urgences pour arrêter une crise.
  2. Une tolérance au médicament se développe en quelques semaines dans la plupart des cas, de sorte que la même dose a moins d’effet au fil du temps.
  3. Les effets secondaires incluent la fatigue, une démarche chancelante, nausées, dépression, perte d’appétit. Chez les enfants, ils peuvent causer une hypersecretion salivaire et une hyperactivité.

Lignes directrices des médicaments antiépileptiques

Il faut parfois plusieurs mois de traitement avant de pouvoir trouver le meilleur médicament et le meilleur dosage pour vous. Au cours de cette période d’adaptation, vous serez surveillé de près avec des tests sanguins réguliers pour mesurer votre réponse au médicament.

Il est très important de garder vos rendez-vous de suivi avec votre médecin et le laboratoire afin de minimiser le risque d’effets secondaires graves et de prévenir les complications.

Si les convulsions persistent malgré le traitement de l’épilepsie, ceci peut être parce que ces convulsions sont des convulsions non-épileptiques. Dans une telle situation vous devriez demander un deuxième avis de spécialiste et faire un Monitorage EEG-video pour réévaluer le diagnostic.

Dans les centres spécialisés, environ 15% à 20% des patients adressés pour des convulsions persistantes qui résistent au traitement, sont en fin de compte d’origine non-épileptique.

Attention ! Ne pas utiliser les commentaires pour les questions de santé au risque de ne pas recevoir de réponse ! Pour vos questions de santé, utilisez le formulaire Question & Réponse et un de nos médecins se fera le plaisir de vos répondre ! Merci.

Débats, discussions et commentaires : 11 commentaires.

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    mon fils prends du kreppra et malgré cela il me fait encore des crises part moment est ce que c est normal?

    [Répondre]

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    « des crises par moment » veut dire combien de crises exactement par mois ?

    [Répondre]

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    Bonjour ! un neurologue a prescrit depuis 2 semaines à mon fils de 8ans de l’Épival. En regardant la liste des médicaments plus haut dans ce document je m’apperçois qu’il n’y est pas .Est-ce un bon médicament pour traiter les convulsions ?…merci de me répondre

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    @marline: oui c’est un anticonvulsivant tu peut les utiliser contre les convulsions, ce qui est décrit dans l’article sont les médicaments les plus utilisés et pas tout les médicaments.

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    Bonjour
    Je prends de l’epitomax et suis très fatiguée j’ai de grosse difficulté de concentration dans mon travail, je voudrais trouverun médicament qui minimise les effets de somnolence et qui ne me fasse pas grossir
    Je faisais des crises généralisées enfant et elles se sont transformées en crises partielles complexes avec sentiment de déjà vécu et ont completement disparu avec epitomax mais les effets secondaires sont l ourds a supporter socialement et professionnellement

    Par avance merci de votre reponse

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    Bonjour mon fils de 2ans qui est sous Depakine depuis 4mois continue de convulser.Les convulsions ne sont plus generalises mais localises a un membre ou a un endroit du coprs et cela tous les 3jours environs .Est normal? Doit on changer de produit?

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    bjr je suis une mére pour une fille de 25 mois qui IMC,malgé son traitemnt elle fais des crises en plus de ça elle trés tendre pour la plupart du temps le traitemnt est comme suit ;dépakine,lamictal,révotril et dés fois méme valium pour libéré les muscle tellemnt son tés dure je vous prié de m’aidé pour trouvé la solutin car a forcé d’étre tendre elle n’arrive méme pas a mangé ou a boire,le someil aussi elle dore pas comment faire ???

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    bjr je suis une mére pour une fille de 25 mois IMC,malgré son traitemnt elle fais des crises en plus de ça elle est trés tendre pour la plupart du temps le traitemnt est comme suit ;dépakine,lamictal,révotril et dés fois méme valium pour libéré les muscle tellemnt son tés dure je vous prié de m’aidé pour trouvé la solutin car a forcé d’étre tendre elle n’arrive méme pas a mangé ou a boire,et manque de someil aussi ,comment faire pour résoudre le problème ??? merci a l’avance

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    Bonjour,
    je souffre depuis plus de 4 ans des crises qui durent parfois 20 minutes des fois 1H depuis ce temps je prend du tegretol lp 400 mais sans amelioration qu’est ce que je peux faire de plus

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    Bonjour, je suis père d ‘une fille de six ans sa fait deux mois quelle a commencer a marche toute seul,elle ne parle pas et elle un retard psyco moteur ,elle a convulser a l’age de 7 mois , cause insuffisance respiratoire a la naissance, elle est rester sous depakine, pendant 2ans,on a fait 2 IRM résulta hydrocéphalie externe,EEG presque toujours pas de tracée significative, a l’age de 3 ans les crises en disparue , alors on a illuminer depakine progressivement comme nous a conseillé le docteur ,puis a l’age de 5ans rechute , elle est sous depakine et elle convulse presque chaque 48 heure surtout ou sommeille avec des crise presque généraliser avec fixation des yeux et grimasse facial ,on est vraiment tourmenter, et ont ne sais plus quoi faire , changer de traitement! changer de docteur! merci de me répondre

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    Bonjour,

    mon bebe a hydrocephalie il prend depakine mais dernierememt il fait des crise .il a fait 2 fois a;nalyse depakimie resultat 40 apres 19 comment faire pour arreter ces convulsions

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